The Burden of Weight on Joint Replacement: A 1.6 Million-Patient Analysis of BMI and Hip Arthroplasty Outcomes

Yaron Berkovich; Shelly Feygelman; Ela Cohen Nissan; Linor Fournier; Yaniv Steinfeld; David Maman

doi:10.3390/surgeries6040095

October 29, 2025SurgeriesOpen Access

The Burden of Weight on Joint Replacement: A 1.6 Million-Patient Analysis of BMI and Hip Arthroplasty Outcomes

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Key Points

To assess how body mass index influences the age at surgery, perioperative complication rates, and resource utilization among patients undergoing elective total hip arthroplasty.
Conducted a retrospective analysis of 1,626,965 elective total hip arthroplasty hospitalizations from the Nationwide Inpatient Sample, excluding fracture and oncology cases.
Stratified patients into three body mass index categories (<29.9, 30–34.9, and ≥35 kg/m²) and identified outcomes and comorbidities using ICD-10 diagnostic codes.
Evaluated primary outcomes—including age at surgery, complications, length of stay, mortality, and hospital costs—using Pearson correlation, linear regression, chi-square tests, and t-tests.
Higher body mass index was significantly associated with a younger age at surgery (r = −0.187, p < 0.001), with each 5-unit increase in body mass index corresponding to a ~2-year decrease in surgical age.
Patients with higher body mass index experienced elevated rates of acute kidney injury, venous thromboembolism, blood loss anemia, and postoperative infections, as well as higher rates of hypertension, diabetes, and sleep apnea.
Hospital length of stay increased alongside body mass index, although total hospital charges demonstrated minimal clinical variation between groups.

Implication

Retrospective analysis reveals earlier surgery and greater complication risks with higher BMI in hip arthroplasty, highlighting the need for risk-tailored surgical planning.

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Cite This Study

Berkovich et al. (2025) studied this question.

synapsesocial.com/papers/6a90389866e43a5679340f49 https://doi.org/10.3390/surgeries6040095

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The Burden of Weight on Joint Replacement: A 1.6 Million-Patient Analysis of BMI and Hip Arthroplasty Outcomes

Key Points

Implication

Abstract

Discussion

Cite This Study

The Burden of Weight on Joint Replacement: A 1.6 Million-Patient Analysis of BMI and Hip Arthroplasty Outcomes

Key Points

Implication

Abstract

Discussion

Cite This Study

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